A discussion about health care was noticeably absent during Tuesday's televised Ontario leaders debate.

None of the six questions posed by the public to the province's main party leaders addressed the issue.

No leader uttered the words doctors or hospitals during the 90-minute debate. Nurses was mentioned once, with eight minutes to go.

While Progressive Conservative Leader Tim Hudak was first to mention health care — 13 minutes in — he did so only as part of a jab at Liberal Leader Kathleen Wynne.

"We see that the scandals keep happening, with Ornge, now with this real estate boondoggle, MaRS, that took $300 million out of health care," Hudak said.

Viewers would have to wait more than an hour to next hear any semblance of a health-care plan.

One hour, 22 minutes into the debate, NDP Leader Andrea Horwarth broadly laid out her party's health-care plan — during her closing remarks.

"Making sure our health-care system works for you, we're going to get wait times in emergency down by 50 per cent. How? Investing in nurse practitioners in the ER, getting rid of the wait lists in home care and long-term care and bringing new family health clinics — 24-hour health clinics — to this province."

Horwath never said where the money for new clinics and nurse practitioners would come from.

Wynne only briefly mentioned health care in her closing remarks.

"Whether it's health care they need or whether it's early childhood education or full-day kindergarten, we need all of those supports in place," Wynne said.

The lack of health-care questions shocked Minister of Health Deb Matthews, who tweeted her surprise on Tuesday.

Health care a massive expenditure

According to the Ministry of Health and Long-term Care, health care consumed 42 cents of every tax dollar in 2012-13.

The ministry also says that without a change of course, health spending would eat up 70 per cent of the provincial budget within 12 years.

'Ontario patients were let down last night.' - Ved Tandan, president of the Ontario Medical Association

"To ensure the health care system is there for our loved ones and future generations, we must start doing things differently," reads a statement on the Health System Funding Reform page of the Ministry of Health's website.

Roger Martin is former dean of the University of Toronto's Rotman School of Management and currently holds the premier's chair in productivity and competitiveness at the school. In April, he released a report that showed doctors' wages have increased 51 per cent between 2002 and 2012.

Ved Tandan, president of the Ontario Medical Association, which represents the province's doctors, called the debate a disappointment.

"Ontario patients were let down last night. Health care was let down last night," he said. "A question about heath care has to be asked during any debate in the province of Ontario when that forms 50 per cent of the provincial budget.

"I also think the leaders, who know how important health care is, should take the opportunity during the debate to raise the health-care issue as part of their remarks.

"We're quite concerned that none of the leaders talked about health care in the debate."

All three leaders broached the subject of health care after the cameras stopped rolling.

Wynne said health care is "a significant proportion of our budget."

"We are keeping costs down in terms of health spending and making decisions, like having everyone in the province have access to a primary care practitioner," Wynne said. "That's the kind of thing that transforms the system and saves jobs, saves money and those are the things that we will continue to do."

Wynne has promised all Ontario residents will access to a primary care provider by 2018 under a Liberal government.

She said that fulfilling the primary-care guarantee would cost less than $20 million and said the costs are covered within the fiscal framework of the 2014 budget, which was rejected by the NDP and PCs earlier this month.

Hudak has vowed to scrap Ontario's Local Health Integrated Networks and divert the savings to frontline employees, like nurses. The LHINs employ about 2,000 bureaucrats and administrators.

"When I see the growth of the fat middle layer at our school boards and our local health integration networks, we'll be better off without those jobs and that waste," he said post-debate. "It'll protect the frontline and help create more jobs in the process."

After the debate, Horwath said she was looking forward to "getting our health care system into a shape that actually meets people's needs."

Tandan said all three parties waited too long to release their platforms.

"I don't think we've been hearing enough about health care at all through the election," he said. "We're not looking for sound bites. We want to hear they are going to invest in health care.

"It's not just health care. It's wellness. It's about providing care for people when they're sick and also preventing people from getting sick."